Overcorrection 'easily cured'

The Dermatology Times issue of December 2005 offered an excellent article by Beth Gilbert with Stephen Mandy, M.D., regarding microdroplet silicone injection, page 51-56.

Dr. Mandy's article is very real and excellent.

One of the concerns expressed in the article regards either overcorrection or development of excess collagen formation, which is infrequently seen, but is seen enough to be of concern. Dr. Mandy explains that this could be a problem; however, there is no way to address the problem.

The technique is simple. A Dermajet (Robbins Instruments) is used, containing a 1 to 4 ratio of Kenalog (Bristol-Myers Squibb) (10 mg per cc) in a ratio of one part Kenalog and three parts Xylocaine (AstraZeneca) 1 percent. This is essentially the standard Dermajet injectable medication for various other skin problems.

The Dermajet, when placed in proximity to the slightly visible and/or palpable microdroplet excess or granuloma site, is effective. One or two injections with the Dermajet usually disperses and/or alleviates the silicone and/or the microgranuloma.

It is an easy procedure, is reassuring to the patient, and usually only a single treatment is required. However, if necessary, the procedure can be repeated after three to six weeks.

The most common sites for overfill or microgranuloma development is in the nasal labia folds, in my own experience. Occasionally, a full-thickness acne scar, triangular or cone-shaped, has silicone placed in the dermis, but it doesn't materially affect the scar. This can result in a small, doughnut-shaped, palpable and/or visible site. The most common site, in my experience, for these developments is the malar or center of the cheek area. The same treatment described above is effective.

The best technician will experience some overfill or microgranuloma development. It is nice to have a remedy!

- George A. Farber Sr., M.D.
Medical Director
Gulf South Medical & Surgical Institute Inc.
Kenner, La.
Co-founder, past president, trustee, ASDS
Co-founder, past treasurer, trustee, AACS
Co-founder, examiner, trustee, ABCS